Provider Demographics
NPI:1518953496
Name:RAMACHANDRAN, MUTHUSWAMI (MD)
Entity Type:Individual
Prefix:
First Name:MUTHUSWAMI
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 STATE ROAD 80
Mailing Address - Street 2:SUITE# 141
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9206
Mailing Address - Country:US
Mailing Address - Phone:561-798-4600
Mailing Address - Fax:561-798-1132
Practice Address - Street 1:13005 STATE ROAD 80
Practice Address - Street 2:SUITE# 141
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-798-4600
Practice Address - Fax:561-798-1132
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32965207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95664Medicare ID - Type Unspecified
FLD82640Medicare UPIN